You may not know this but Massachusetts has a mandatory health care bill that combines discounts and legislature to allow everyone in their state who wants it to afford health care. That's an example of what states can do. So I'm not sure what you think these terrible harsh results are going to be. A state can do anything the country can, short of starting a war or violating people's constitutional rights. There's no reason to think we would fall apart under a measure of government that was the prevailing one for over 100 years of our history.